Monoclonal antibodies to the pro-inflammatory cytokine tumor necrosis factor-alpha have shown efficacy in treating Crohn's disease. However, these can be immunogenic.
Soluble tumor necrosis factor-binding proteins may be an alternative anti-tumor necrosis factor agents in Crohn's disease.
Researchers from Belgium and Switzerland investigated onercept, a recombinant form of the natural human soluble p55 tumor necrosis factor receptor, in patients with active Crohn's disease.
In this pilot study, 12 patients with active Crohn's disease were randomized to receive onercept at either 11.7 or 50 mg, 3 times weekly for 2 weeks.
The team then followed up patients for 6 months after the end of treatment.
|Crohn's disease activity index decreased rapidly during treatment in both groups.|
|Alimentary Pharmacology and Therapeutics|
The researchers found that the Crohn's disease activity index decreased rapidly during treatment in both groups.
They observed 7 responses (a Crohn's disease activity index decrease of 100 points) during the first 6 weeks of the study. These responses included 5 remissions (a Crohn's disease activity index decrease of 150 points).
Furthermore, the team found that improvement was sustained for 2 to 4 months after stopping treatment.
The treatment was well tolerated and no patients developed antibodies to onercept.
Dr Rutgeerts's team concluded, "Neutralizing the activity of tumor necrosis factor-alpha with its soluble p55 receptor may be valuable in the treatment of patients with Crohn's disease".
"Larger placebo-controlled trials are indicated."